Somerville Reflects on First Months and Vision for Nursing

Jackie Somerville spent her first few months at BWH touring inpatient and ambulatory care units and meeting with as many staff nurses and nursing leaders as possible. She plans to continue this during the next few months.

Throughout Jackie Somerville’s career in nursing, one guiding principle has shaped the care she provided as a staff nurse, the research she conducted and the decisions she makes as a leader: that the patient must feel known as a whole person by the nurse.

Somerville believes this is one of the most important aspects of care, and one that truly provides the foundation for healing. In her first months at BWH as senior vice president of Patient Care Services and chief nursing officer, she already has seen evidence that BWH patients are experiencing this kind of relationship with their nurse.

Prior to joining BWH, Somerville served as associate chief nurse of the cancer center, neurosciences, surgical specialties and orthopedics at Massachusetts General Hospital. There, she was part of a group that created a patient and family advisory board to ensure that patients and families had an opportunity to provide feedback about their experiences and suggestions for improvement. For Somerville, the regular meetings with patients helped to ensure the decisions she made as a leader truly reflected the best interests and wishes of patients and families.

In this interview with BWH Nurse, Somerville reflects on her first months at BWH and what she’s learned during her visits to clinical areas throughout the hospital, where she has spoken to as many nurses, patients and families as possible.

“I’m humbled to have this opportunity. I really am,” she said. “The last five years have been incredible for BWH nurses in laying a foundation for the Department of Nursing’s work, and I can’t wait to see what the next five will bring.”

You have served in a number of nursing leadership and staff nurse positions since beginning your career. What initially drew you to the field of nursing?

I have two older sisters, both of whom became teachers. I was determined to do something different, but I wanted a career in service to people, so I became a nurse.

During my freshman year of nursing school, I had an experience that affirmed I had made the right decision. I was diagnosed with melanoma, which was a life-altering experience. The nurses who took care of me were incredibly smart and compassionate. They got to know me as a person and who I was before this diagnosis. They wanted to help me get back to that place. I never forgot my nurses and the way they treated me. That experience taught me early on about the kind of nurse I needed to be.

What attracted you to Brigham and Women’s Hospital?

I was drawn to BWH for a number of reasons, including the hospital’s reputation for clinical excellence and the sense of pride and community I experienced here during my interviews. Having grown up in Boston and being part of this community for so long, I’ve met many nurses who work in different places. The nurses who work at the Brigham seem to have a sense of great pride about working here, and the longevity of their dedication—those with 20, 30 and 40-plus years of service—really is a testament to that.

I also enjoy working in an academic medical center because of the teaching and research components of the mission. It’s our responsibility to prepare the next generation of nurses and health care professionals, and the opportunity to participate in research to advance our knowledge is critical, especially during this evolving time in health care.

In your first months at BWH, you have spent time touring both inpatient units and ambulatory practices to meet nurses and patients. What qualities have you noticed about the type of care patients receive at BWH?

It’s been incredibly energizing to speak with staff, patients and families. Patients and families have opened up to me about their gratitude for nurses who have gone on a journey with them through a truly life-altering experience.

In every unit and practice, nurses’ commitment to patients and their families is truly evident in everything they do. I saw and heard about how they will go the extra step to ensure the care they provide is meaningful to each patient. No two patients are the same, and the nurses here really get to know each one as an individual so they can shape the care accordingly. Nurses are also enthusiastic about engaging families in care—it’s very clear that families are our partners in care.

Could you describe one instance that illustrates this kind of nurse-patient relationship?

I saw many examples, but one that comes to mind immediately happened on a Hematology/Oncology unit. A patient who had been here for more than a month invited me into his room and told me that he would not have gotten through this experience without the support of his nurses. They made his stay so much better because of their efforts to get to know him. He liked Dunkin’ Donuts coffee, for example, and one of the nurses would pick him up a cup on her way in.

Another nurse would always ask him about his family and how he was doing as she was providing highly technical care. But she did it in a way that didn’t focus on technology—it focused on him as a person. These acts of kindness really make a difference to a patient, especially one who has been in the hospital for so long.

What was underlying his story is that he knew that the care they were providing was safe and that he could be confident in their ability to take care of him. Nurses came into his room intentionally to engage him and let him know they cared about him. He got teary as he told me his story. It was an incredibly powerful experience for him. Fortunately, he was preparing to go home, but if he ever has to come back, he informed me that he wants to be on that unit with his nurses.

What is your vision for the Department of Nursing?

<It is our collective vision as a department to provide excellent nursing care with the best staff in the safest environment.

I plan to meet with as many nurses as I can and listen to their ideas and needs so that we can make things even better. When people talk about BWH, I want them to say that we provide the best nursing care in the world. I want us to continue attracting and retaining the best nurses so that we can achieve that goal.

The department has evolved in the past five years, with a committee structure in place to help staff nurses achieve the department’s vision. Will that work continue?

The committee structure is incredibly impressive. Nurses from different units are coming together to make and shape decisions about their practice, quality and safety, informatics, patient education and standards, policies and procedures. We must continue this work and build on it even more. At some point, we may consider how to integrate the voice of the patient into our committee structures.

The past five years have really laid a foundation for this department’s work, and I look forward to building upon that foundation with all BWH nurses.

You’ve come to BWH at a time when the hospital is undergoing a strategic planning initiative to rethink many processes, including the delivery of care and patient affordability. What role does nursing play in the hospital’s strategic planning initiatives?

Nurses are actively involved in these discussions and members of the strategic planning team.

Look at the exquisite care we provide. There is a huge opportunity for all roles in nursing to contribute. Hospitals are wonderful places, but most patients would rather be at home. We must consider how we can partner with patients to make that happen.

The Institute of Medicine Report, “The Future of Nursing,” focuses on how nurses need to sit at the table with doctors to talk about reshaping the health care environment. We want to really maximize that collaboration to strengthen our efforts to plan for the organization’s future.

This is an exciting time to be part of discussions on care redesign and patient affordability. The incredible minds we have here are coming together in a way they haven’t before to reshape the system, to think about things like hand-offs and how to prevent patients from falling through the cracks, as well as chronic disease management. There is tremendous opportunity here.

The research you have conducted focuses on patients’ perceptions of feeling known by their nurses. Why did you study this, and what did you find?

The nurse-patient relationship is really the vehicle for healing. That’s how it happens. When you are in the care of a nurse, you realize how incredibly smart and compassionate they are. Through this study, I wanted to make this special relationship known publicly.

Patients told me that when they believed that nurses knew them as a whole person, they felt safe. They knew the nurses would pass all of their information along to the next person so they didn’t have to keep repeating themselves. The relationship also empowers them to participate in their care. Nurses encouraged them to do this.

I’d love to study the long-term effects of this important nurse-patient relationship. For example, when patients feel known by their nurse, do they have better outcomes? Are the nurses happier, and if so, do they stay with the organization longer? I think there’s real power in this relationship. I hope to continue my research eventually.

For now, though, my priority is continuing to meet with and hear the voices of nurses throughout the institution and help them to achieve our department’s vision and the mission of BWH.

About Dr. Somerville

Hometown: Grew up in Cambridge; now resides in Newton.

Family: Two sons, Connor and Jake; married to her high school sweetheart, Bob.

Education: A graduate of Boston College with a bachelor’s of science in nursing, she received her master’s in nursing administration from Boston University and her PhD in nursing from Boston College.